Health at Every Size vs Size Acceptance

DefendThis is a re-post because there always seems to be a lot of confusion understanding the difference between Health at Every Size and Size Acceptance, or suggesting that Health at Every Size should be required for Size Acceptance if a person is fat.  Most recently, I saw a comment on Facebook that said “It’s time to stop stigmatizing us healthy fatties.” Um, no.

I believe that Health at Every Size and Size Acceptance are two separate things with separate, though sometimes overlapping, goals. That’s because I do not think we should involve the concept of health in the fight for fat civil rights, including the end to weight-based bullying, stigma, and oppression.

Let’s start with HAES.  There are lots of different ideas about what it means to practice HAES.  There are people who think there are things you have to do for your lifestyle to be considered “HAES” – some say you have to do intuitive eating, some say you have to exercise in a specific way, or that you aren’t allowed to do any kind of food measurement etc.  I think the definition of HAES should be any personal health practice that is behavior-centered and weight neutral.  So health is pursued through behaviors and without an attempt to manipulate body size. People’s prioritization of their health and the path they take to get there is up to them and any health care providers they choose to consult, and it cannot be said often enough that health is not an obligation, barometer of worthiness, or entirely within our control.

I think there is activism to be done around HAES, especially as it relates to access.  Nobody is required to practice HAES or any other health practice, but if you want to practice habits that you believe will support your health then there shouldn’t be barriers to that – you should have access to the foods you choose, movement options that you enjoy that are both physically and psychologically safe (so that you can, for example, go swimming at your gym’s pool without any fear of being shamed), and affordable evidence-based healthcare (so your doctor listens to you and gives you interventions proven to help your symptoms and does not bring up weight other than if there are unexplained gains or losses, or to prescribe a proper dose of medication.)  There is tons of work and activism to be done around access and it’s really important work.

I don’t think that we should use HAES as a platform to do Size Acceptance activism because I think that we should avoid even the intimation that some level of health or healthy habits is required for access to basic human respect and the rights to life, liberty and the pursuit of happiness.  There is absolutely NO health requirement to demand your civil rights. Nobody owes anybody else “health” or “healthy habits” by any definition.  You do deserve, and have the right to demand, respect and the rights to life, liberty and the pursuit of happiness in the body you have right this minute – whatever your size, health, habits and dis/ability.

I am both a SA and HAES activist, but I approach my activism very differently.   I am a Size Acceptance Advocate – everybody deserves basic human respect and civil rights and that should never be up to show of hands or vote of any kind. Fat people have a right to exist, there are no other valid opinions about that. Our rights to life, liberty and the pursuit of happiness are not someone else’s to give, they are inalienable.  SA activism is not about asking someone to confer rights upon us but rather demanding that they stop trying to keep them from us through an inappropriate use of power.

I am a Health at Every Size Practitioner.  I practice HAES and talk about it publicly because there are so many people who aren’t even aware that a weight-neutral approach to health exists. I leave room for the fact that others choose different paths to health, and I respect those decisions as I want my decisions respected. I put my fat body on display (and therefore myself up for criticism) because I am a fathlete and I get to exist and tell my story; and because so many fat people tell me that they wanted to be athletic but didn’t think they could until they saw someone else doing it, because the message they received from society again and again is that it’s not possible. Fat fitness professional Jeanette DePatie, and I created the Fit Fatties Forum (which now has more than 2,500 members) so that people who want to can have a place to talk about fitness from a weight-neutral perspective.  But if you read this blog regularly you know that I constantly  point out that nobody has to do what I do and that doing what I do doesn’t guarantee that another person will have the same results that I have, or that I will always be healthy and athletic.  Nor does it make me better or worse than anyone else.  Health is not a moral high ground, it is multi-dimensional, never fully within our control, and our prioritization and health path are personal.

As always, I can only speak for me and this is what I think.  There are a lot people who disagree about this, many of whom I hold in the highest esteem.  I think it’s a good conversation to be having and I think that we can continue to do the activism work even as we have an ongoing discussion to clarify our beliefs around it, that is the nature of the stage of civil rights activism that our community is in. EDIT: Reader Annie just made me aware of this perspective on the same subject from The Fat Word

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6 thoughts on “Health at Every Size vs Size Acceptance

  1. Unfortunately it seems that “acceptance” is the kind where they praise the “normal” sized Miss USA contestant for being brave enough to wear a bikini. She is 5’8″ and a size 4! That sort of thing really disheartens me, the idea that a tall leggy woman with a BMI of 18 (considered underweight by medical standards) is the public’s idea of expressing acceptance of different body types. Then one of the Williams’ sisters gets criticized for having “giant” thighs… ya, the giant thighs that propel her around the tennis court. It is almost too much to hope that people, especially the press and marketers will treat normal women with anything more than disgust.

    1. I saw that news story too and was rolling my eyes so hard. It’s similar to what the industry considers a plus sized model. By those standards, I could get back to my malnourished & gaunt 18 yr old self and still be considered “plus sized” because of my butt, thighs, and size I wore.

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